Originally published in: Addiction Help

Not to be confused with obsessive-compulsive disorder (OCD), obsessive-compulsive personality disorder (OCPD) is a different mental health condition impacting between 2.1 to 7.9% of the general population.

OCPD traits often make it difficult for individuals to break from rules, organization, and ever-elusive perfection. These individuals need help delegating tasks to others in a work environment because they often fixate on details, even if it slows down progress.

What is Obsessive-Compulsive Personality Disorder?

The American Psychiatric Association (APA) defines obsessive-compulsive personality disorder (OCPD) as a pervasive pattern of preoccupation with orderliness, perfectionism, and mental and interpersonal control, at the expense of flexibility, openness, and efficiency.

People with OCPD experience significant impairment in their daily lives due to an obsession with following the rules (sometimes known as excessive conscientiousness). Their high standards often cause them to struggle with being flexible in situations, which leads to slower work and interference in completing tasks.

The inflexibility of OCPD can affect every facet of the person’s life, from work or school to relationships and home life. For example, a person may find it challenging to work with others because they overcomplicate a project or become upset if a coworker suggests an alternative solution. Even if things are running behind schedule, people with OCPD may reject help and insist on controlling every aspect of the project.

OCPD Life Impact

Outside of work or school, OCPD can wreak havoc on interpersonal relationships due to the person’s fixation on work or productivity. Often the obsession with working becomes so intense that leisure activities and relationships get neglected. Even when engaging in relaxing activities or social outings, the individual may over-organize plans and struggle to enjoy any part of the experience.

Outsiders may perceive a person’s OCPD personality traits as stubbornness or a personal failing, not understanding that obsessive-compulsive personality disorder is an actual medical condition versus a simple personality issue.

Despite the rigid beliefs those with OCPD may struggle with, proper treatment can make all the difference in their quality of life. With the right combination of therapy and support from family members, people with this disorder can find more balance in life and enjoy social activities without the burden of perfectionism.

About Personality Disorders

Personality disorders are a group of mental illnesses characterized by abnormal, unhealthy, and inflexible patterns of behaviors and thoughts. These behaviors often cause severe problems with interpersonal relationships, work, and school.

People with personality disorders often have trouble dealing with everyday stresses and problems and experience turbulent relationships with others. Despite these issues, it’s typical for patients to be unaware of their disorder, as their thoughts may seem perfectly natural to them.

The Diagnostic and Statistical Manual of Mental Disorders 5th Edition (DSM-5) lists ten personality disorders, separating them into three main clusters based on shared traits and symptoms.

The three clusters include:

Cluster A (abnormal, eccentric)

• Paranoid Personality Disorder

• Schizoid Personality Disorder

• Schizotypal Personality Disorder

Cluster B (overly dramatic or unpredictable)

• Antisocial Personality Disorder

• Obsessive-Compulsive Personality Disorder

• Narcissistic Personality Disorder

Cluster C (anxious, fearful)

• Avoidant Personality Disorder

• Dependent Personality Disorder

• Obsessive-Compulsive Personality Personality Disorder

Symptoms of Obsessive-Compulsive Personality Disorder

People with OCPD usually feel the need to be in control of everything, a trait that often causes them to be more solitary and mistrusting of offers for help. Because of their rigid view on how things should get done, it can be hard to collaborate with others.

These individuals fixate on perfectionism and organization to an unhealthy, compulsive extent. They also often focus on logic and intellect, showing intolerance for emotional or expressive reactions. People with OCPD often tightly control their thoughts and actions to achieve perfection, much to the detriment of their well-being and relationships with others.

Symptoms of OCPD may include:

• Excessive devotion to work that impairs social activities

• Compulsive fixation with lists, rules, and minor details

• Perfectionism that interferes with tasks getting finished

• Rigid and unyielding adherence to moral and ethical codes

• Hoarding behaviors or an unwillingness to throw out worn-out or worthless objects, even those with no sentimental value

• Reluctance to delegate or work with other people unless they do things the desired way

• Incredibly frugal because they see money as something to be saved for future disasters

Obsessive-Compulsive Personality Disorder VS Obsessive-Compulsive Disorder

Obsessive-compulsive personality disorder (OCPD) and obsessive-compulsive disorder (OCD) are frequently confused, and it’s easy to see why. Their names and abbreviations are incredibly similar, as well as their symptoms. However, at their core, these two mental illnesses are quite different.

The most significant difference between OCD and OCPD is the root cause of the behavior. Obsessive-compulsive disorder is characterized by intrusive, unwanted thoughts or behaviors that cause anxiety and distress. The patient will often cope with these intrusive thoughts or obsessions with compulsions or ritual behaviors to quell irrational fears.

For example, someone with OCD may have constant obsessive thoughts about germs and wash their hands so often that their skin becomes overly dry and painfully raw. The obsessive thoughts over germs are what’s driving the compulsive behavior.

The same obsessions or compulsions do not drive obsessive-compulsive personality disorder. Their rigid beliefs on cleanliness or organization may look like an obsession, but it’s part of their personality. So, while a person with OCPD may also constantly wash their hands, intrusive thoughts or distressing emotions are not the cause like they are with OCD.

Development of Obsessive-Compulsive Personality Disorder

Unfortunately, the exact cause of OCPD remains unknown. Based on current research, OCPD is thought to be caused by genetics and childhood experiences. Similar to the cause of other personality disorders, specific genes may make an individual more vulnerable to developing OCPD.

Risk Factors

People with severe OCD are more likely to be diagnosed with OCPD. While this disorder affects men and women, the International OCD Foundation reports that men are twice as likely to be diagnosed with OCPD than women.

Because genetics play a significant role in the development of OCPD, it’s helpful to be aware of any personality disorders or mental illnesses in the family. As an individual’s personality forms during childhood, research has shown that neglect, abuse, and traumatic situations can trigger the development of OCPD.

How Common is Obsessive-Compulsive Personality Disorder?

According to the Journal of Personality Assessment, 2–7% of the population has OCPD, making it the most common personality disorder. Although OCPD is more prevalent in males, females can still develop this disorder.

Symptoms of OCPD commonly manifest in their late teens and early adulthood. Sometimes, these symptoms are mistaken for OCD and not a personality disorder. That’s why working with a mental health professional and being honest about your symptoms is essential to ensuring an accurate diagnosis.

Common Comorbidities and Related Conditions

Many people with a personality disorder find they fit the criteria for other personality disorders. However, the most common comorbidities found in OCPD patients include:

• Eating disorders (e.g., anorexia nervosa)

• Depression

• Illness anxiety disorder (hypochondriasis)

• Other similar mood disorders

• Parkinson’s disease

• Substance use disorder and/or alcohol use disorder

Obsessive-Compulsive Personality Disorder and Addiction

According to research published in the Journal of Psychology & Clinical Psychiatry, rates of substance use disorder are lowest for people with OCPD compared to all other personality disorders. However, alcohol use disorder is a common comorbidity associated with OCPD.

Diagnosing Obsessive-Compulsive Personality Disorder

A licensed mental health care provider or psychiatrist will determine if you or your loved one meets the criteria for an OCPD diagnosis based on the DSM-5.

Proper diagnosis of OCPD requires that the patient meets certain criteria, as well as an in-depth evaluation and the use of tests like the Personality Diagnostic Questionnaire. After detailing your history and looking over the testing results, your doctor can make an accurate diagnosis.

Treatment for Obsessive-Compulsive Personality Disorder

Next, they will help you create a treatment plan that best suits your unique needs and struggles.

OCPD treatment generally includes a combination of medication and psychotherapy or “talk therapy.” The most common type of psychotherapy used in the treatment of OCPD is Cognitive Behavioral Therapy (CBT), which focuses on identifying unhealthy, self-destructive behaviors and redirecting them more beneficially.

Regarding medication, SSRIs or anti-depressants have proven to be highly effective in controlling common OCPD symptoms related to anxiety and depression. SSRIs (selective serotonin reuptake inhibitors) help by stopping the reabsorption of mood-boosting serotonin, so there’s more of it in the brain.

Finding the Best Treatment For Obsessive-Compulsive Personality Disorder

Although personality disorders can be highly stigmatized, OCPD is treatable with the proper guidance. If you or someone in your life is showing signs of OCPD, there are treatments available that can improve your quality of life immensely. With the right treatment plan and support from loved ones, individuals with this disorder can strengthen relationships and find more flexibility in their lives.

FAQs about Obsessive Compulsive Personality Disorder:

What causes obsessive-compulsive personality disorder?

Obsessive-compulsive personality disorder is thought to be caused by genetics and trauma in childhood. Specific genes can make an individual more vulnerable to developing the disorder, especially if they grow up in a traumatic or abusive environment.

Who is most likely to develop obsessive-compulsive personality disorder?

Around 2–7% of the population has OCPD, making it the most common personality disorder. While any gender can develop OCPD, men are twice as likely to get diagnosed with this disorder. Anyone with a history of personality disorder in their family may be at a higher risk of developing OCPD under the right conditions.

What are the signs of obsessive-compulsive personality behavior?

Common signs of OCPD include an excessive devotion to work and perfectionism that impairs social activities, compulsive fixation on rules and lists, and hoarding tendencies.

People with OCPD often struggle to work with others, delegate tasks, or enjoy social activities. Because they are so rigid in their beliefs and fixation on perfection, their relationships and work or school life tend to suffer.

How is obsessive-compulsive personality disorder treated?

OCPD treatment usually involves a combination of therapy and medication. Cognitive Behavioral Therapy (CBT) can be incredibly effective in helping patients identify unhealthy thought patterns and give them skills to handle difficult situations better.

SSRIs or antidepressants are first-line medications for OCPD, as they can help increase the amount of serotonin in the brain and lessen specific symptoms like depression and anxiety.